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Tebikenimwakin village. Communities in South Tarawa who have no land to live on, build on land that was part of the lagoon. They fortify it with tyres, cement walls and piles of rubbish and palm fronds - but the king tides periodically sweep through their homes, killing trees and destroying their kitchen gardens.

Environmental Degradation

Communities in South Tarawa who have no land to live on, build on land that was part of the lagoon, fortifying it with tyres, cement walls and piles of rubbish and palm fronds. Kiribati, March 2023.
© MSF/Nicolette Jackson
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Environmental degradation accelerates climate and environmental vulnerabilities through ecosystem disruption. Deforestation, soil erosion, and pollution intensify floods, droughts, and disease transmission. These compound existing health risks—malnutrition surges with failing crops, respiratory illnesses worsen with air pollution, and waterborne diseases spread as freshwater systems collapse.

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Air Pollution as a Critical Climate Adaptation Challenge
 

This report highlights air pollution as a major environmental and health crisis, driven by fossil fuel combustion, industrial processes, and climate-amplified events like wildfires and dust storms. It details how pollutants (PM2.5, NO₂, SO₂, etc.) harm respiratory, cardiovascular, and neurological health, with disproportionate impacts on vulnerable populations—mirroring MSF’s humanitarian priorities. Critically, it underscores the climate-air pollution feedback loop: heatwaves intensify pollution (e.g., ozone formation), while droughts and deforestation increase dust storms and wildfires.

Read the Air Pollution Spotlight

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MSF232715 Smog rises above Kamrangirchar, a heavily polluted slum area in Dhaka
Additional Information / Shotlist Kamrangichar is the biggest slum in Dhaka, located in a peninsula area of around 4km2 and home to over 400,000 people. The slum is situated next to the Buriganga River, which is black in colour and gives off a strong odor, as it receives thousands of cubic meters of untreated toxic waste from the tanneries, factories and homes in the area.
Kamrangirchar hosts hundreds of small-scale factories working on plastic recycling and reprocessing, metal smelting, welding and moulding, battery manufacturing, textiles and other activities. From the 1960s until 2017, the adjoining Hazaribagh neighbourhood was home to 95% of Bangladesh’s leather industry tanneries.

Workers are highly exposed to physical and chemical hazards, working without protective clothing, often barefoot, in poorly ventilated conditions. This subjects them to occupational hazards such as injuries, skin disorders, respiratory problems, etc. The factories are located in the midst of residential areas, often in the same buildings as homes. High rates of poverty, combined with poor living and environmental conditions, also contribute to high levels of intimate partner violence.

MSF has operated primary health clinics in Kamrangirchar since 2014, providing occupational health consultations, vaccinations, adolescent reproductive health services and response for survivors of sexual and gender based violence. Outreach teams also engage in health promotion activities in the community, schools and factories. 

Special instructions: All consent given 
© Connor Hana
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Lead Poisoning Prevention as a Climate-Adaptive Health Measure
 

This articleby OCA documents the successful intervention in Zamfara, Nigeria, where lead poisoning from artisanal gold mining killed hundreds of children. Key actions included environmental remediation (soil decontamination), chelation therapy, and community-led safer mining practices to prevent re-exposure. Over 11 years, MSF screened 8,480 children and treated 3,549, ultimately halting child fatalities before handing the project to local authorities.
 

This case underscores how environmental degradation and climate pressures intersect with health crises, offering a replicable framework for adaptive humanitarian responses.

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A worker shows the mercury-gold amalgam at the Bagega gold processing site. The sand containing the gold has been added to a bowl that also contains mercury. The mercury attracts the gold and both elements are combined, extracting the gold from the sand and stones and elements, like lead. This then goes into a small cloth, and any moisture in the mercury-gold combination gets squeezed out. Leaving a neat ball of mercury and gold. After this the mercury will be burned, and what is left is gold.

A worker shows the mercury-gold amalgam at the Bagega gold processing site. Nigeria, 2012.

© Olga Victorie/MSF